Services that are not state operated are not the state's fault when they screw up - they can also blame the trains, fuel prices etc and be the good guys in standing up for consumers rather than being the ones who are at fault.

Health services need to be honest: certain things are too expensive to do and keeping the elderly alive costs more than we have since when they are better they continue to cost a fortune.

But no one wants that conversation - to cut beds for no-hope premature babies since the papers cite the one who bucks the odds, free drugs for "at risk" gay men (as having to use free condoms is so last millennium) and on course oncology and rare diseases - a bottomless pit where nigh on infinite money can be spent.

Private companies would have to rationalise as we all know has to happen.